Active NPI
Rahul Ved Prakash, DDS
- Dentist
- Shorewood, IL
National Provider Identifier
1730312455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019028741
- Practice address
- 964 Brook Forest Ave
Troy Dental
Shorewood, IL 60404-8807 - Phone
- (515) 664-5357
- NPI assigned
- Aug 27, 2009
- Last updated
- Aug 6, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 58773 | CA | |
| Dentist | 122300000X | 019028741 | IL | Primary |
Addresses
Primary practice location
964 Brook Forest Ave
Troy Dental
Shorewood, IL 60404-8807
Mailing address
964 Brook Forest Ave
Troy Dental
Shorewood, IL 60404-8807
Phone (515) 664-5357
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019028741 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rahul Prakash, DDS, PLLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375747200000",
"number": "1730312455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "964 BROOK FOREST AVE",
"address_2": "TROY DENTAL",
"city": "SHOREWOOD",
"state": "IL",
"postal_code": "604048807",
"telephone_number": "515-664-5357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "964 BROOK FOREST AVE",
"address_2": "TROY DENTAL",
"city": "SHOREWOOD",
"state": "IL",
"postal_code": "604048807",
"telephone_number": "515-664-5357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VED PRAKASH",
"first_name": "RAHUL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-27",
"last_updated": "2013-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "58773",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019028741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shorewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.